Betty Anyanwu-Akeredolu woke up one day and had no cause to feel anything was wrong with her. She felt great and naturally had no reason to believe anything was amiss with her health. Then, she decided to have her bath. And her world came crashing like a ceiling that caved into a severe storm. It was in 1997. As she was having her bath, her fingers touched something on her. A lump? She told herself it could not be. It was a denial she did not even believe herself. Her emotions ran riot and fear took over her entire being.
For one week, she kept it to herself. She could not share the fear that she had breast cancer with anyone. Not even her husband or family doctor. She was under terrific emotional trauma. Not even her husband’s belief that she was withdrawn could draw her out.
But an angel soon came. The angel came via the a cable show. According to her, "I tuned to cable TV and chose UK living and there was Rolanda’s show tilted "this programme can save your life." It surely did, for it was about breast cancer survivors. That programme gave me what I needed most at that point in time hope that I could be a survivor too. It was the greatest spiritual upliftment I have ever had in my entire life."
She said: "By the following week, I summoned courage and went to an Alumna (University of Nigeria), Dr. Ubah at University College Hospital, Ibadan for palpation. She at last confirmed the presence of a lump. Cold reality. Numb shock. What kind of lump? Benign or malignant? It was rather too early to conclude as biopsy was yet to be carried out. However, it is pertinent to mention that by the time of confirmation of the malignancy, I had gathered myself, shut out emotions and was ready for whatever it would take to make me free of the affliction. My emotional preparedness, I want to believe, helped a lot in dealing with the problem. Without delay, on April 29, 1997, I had surgery at the University College Hospital, Ibadan successfully performed by a most caring team of doctors led by Dr. O.O. Akute (FRCS- Fellow Royal College of Surgeons). The best part of the good news was that my cancer was at stage 1 with the axillary nodes free of cancer cells."
Thanks to Rolanda’s Show, Anyanwu-Akeredolu came out of her quietude. But there are thousands of women and men currently groaning in silence over breast cancer and other forms of cancer in different parts of Nigeria.
Many are confused and find themselves pacing up and down, with beads of perspiration forming beneath their collars. Anyanwu-Akeredolu, who after surviving her ordeal founded Breast Cancer Association of Nigeria (BRECAN), said it is not unusual for people to groan in silence.
"While in the hospital, I noted the generally high level of fear, apprehension and secrecy among breast cancer patients. Nobody wanted to talk about it. Majority of the patients, due to ignorance and poverty were at the late stages of the disease when little help could be given. The lucky ones who had successful treatment shied away from discussing their experience. They simply got treated and walked away with sealed lips. Some that I managed to engage in discussions disclosed that their husbands would never let them go public about their experience with breast cancer, apparently fearing stigmatisation," she said.
It is in order to stop the silence associated with breast cancer that the month of October has been set aside worldwide to create awareness about the disease. In Nigeria, where the pandemic is on the increase, non-governmental organisations working in the area of cancer have used the month to hold events aimed at improving the awareness about breast cancer, the need for government to provide test centers and treatment facilities. Some have also used it to promote the need for legislations, which promote healthy living.
Interestingly, the need to pass the National Tobacco Control Bill, which is before the Senate has also found a space this month. The Senate Committee on Health led by Iyabo Obasanjo-Bello has held a public hearing on it, after it passed the second reading. The passage of this bill automatically means a domestication of the World Health Organisation’s Framework Convention on Tobacco Control (FCTC), a global treaty which Nigeria has ratified and is obligated to domesticate. The FCTC prescribes measures that discourage smoking and promote healthy living.
Though the causes of breast cancer have not been conclusively found, tobacco use is associated with many forms of cancer and causes 90 percent of lung cancer. Tobacco smoke contains over fifty known carcinogens, including nitrosamines and polycyclic aromatic hydrocarbons. Tobacco is responsible for about one in three of all cancer deaths in the developed world, and about one in five worldwide.
This is why the Programme Manager of Environmental Rights Action (ERA), Akinbode Oluwafemi, said it was time the Senate passed the National Tobacco Control Bill.
Akinbode told a press conference that "nobody at the public hearing, including tobacco industry lobbyists contended the lethal consequences of smoking."
He said: "Tobacco currently kills over 5.4 million people annually, over 70 per cent of those deaths occur in developing countries. Also, nobody at the public hearing (again including the tobacco companies) objected to the passage of the bill. The tobacco companies only raised a few inconsequential and unsubstantiated objections to a few provisions. Those objections were roundly defended through our presentations.
"In addition, the Public Hearing was the biggest opportunity to unpack some of the lies being peddled in the media about possible negative consequences of the bill. The bill as appropriately titled is to control tobacco consumption so as to reduce the deaths, ill-health, social, economic and environmental costs associated with tobacco use. The bill has no provision about outlawing or forcefully closing down tobacco factories as being circulated in a section of the media. At the public hearing, the tobacco industry and their agents finally put paid to their widely peddled fairy tale of massive job losses if the nation implement effectives tobacco control laws."
He further explained that "In fact, the British American Tobacco Company Nigeria, the company which controls over 82 per cent of the Nigerian cigarette market, in its presentation at the public hearing, allayed all fears of massive job losses when it disclosed in the presence of distinguished Senators that it has 850 staff. To further debunk the massive job loss propaganda, the Association of Tobacco Wholesalers and Association of Tobacco Retailers put their combined staff strength at about 4,000. Thanks to the public hearing and the Senate Committee on Health, Nigerians now know for a fact that the 300,000 or 500,000 job propaganda is huge lie."
He said the only way forward is that "Senator Obasanjo-Bello and members of the committee should fire at full speed to present the Bill before the Senate plenary. We urge the Senate to complement the success recorded by the Health Committee and the example shown by the Osun State House of Assembly by fast tracking the National Tobacco Control Bill. Nigerians are dying by the seconds due to tobacco addiction while tobacco manufacturers smile to the banks. Every delay is more deaths, more ill-health. Nigerians and indeed the entire world are watching. We are waiting."
While the waiting game continues, experts have pointed out that though women may be more affected, but breast cancer is not exclusive to women. In fact, experts say it kills men faster because they are flat-chested. Statistics from the Nigerian Institute of Medical Research (NIMR) shows that men account for 20 percent of cancer cases in the country. This means one in every hundred men, as against two in every hundred women, are affected by breast cancer.
The statistics are generally glooming. Of all cancer cases that have been recorded in Nigeria, breast cancer is the leading killer, with over 30,000 cases recorded annually. Globally, not less than 400,000 women are lost to breast cancer annually.
No wonder the Executive Director of International Union Against Cancer, Isabel Mortara, said "each year, the number of women diagnosed with breast cancer and dying from it rises and the gap in survival rates between developed and developing countries widens."
It is for this reason that Anyanwu-Akeredolu said: "Cancer in general is a word that strikes fear into the heart of everyone. It is a sure killer if allowed to take control."
Another breast cancer survivor and promoter of Bloom Cancer Care and Support Centre, Dr. Kofoworola Orija, said "our personal experience of breast cancer is indeed a social issue. Every woman battles through her disease so as to bounce back in life striving to be part once more of an inclusive society."
For breast cancer patient, there are stages of cancer, which basically indicate how far cancer cells have spread within the breast to nearby tissue and other organs. Carcinoma in situ refers to the condition when cancer is static in the ducts and has not spread to other organs of the body. It has two types known as Lobular Carcinoma in Situ and Ductal Carcinoma.
Stage 0 is that stage when the cancer cells are still within the duct. By the time it gets to stages 1 and 2, the cancer has invaded nearby tissue. At stage one, the cancer is two centimetres and once it has gone beyond two centimetres, it has entered the second stage and might have spread to the lymph nodes under the armpit. At these two stages, it is not yet critical.
The critical stages begin from stage three when the cancer has grown beyond five centimetres and have spread to the lymph nodes. It is also possible that it would have spread to the chest wall, inside the chest and the skin.
As for stage four, the cancer has invaded the lungs and the bones, aside spreading to the lymph nodes. Both stages three and four are critical.
As a way of catching the lump early and killing it, the American Cancer Society (ACS) recommends annual mammogram from age 40. Mammogram is a test carried out to detect lump. ACS also recommended clinical breast examination every three years for women in their 20s and 30s and older. Also, it advises women to know how their breasts normally feel and report any change to healthcare providers. "Women at risk should talk with their doctors regularly about the benefits and limitations of starting mammography earlier, having additional tests or having more frequent exams," the ACS recommends.
It also prescribes breast self-examination (BSE) for women starting from their 20s.
BSE, says Ebunola Anozie, who is the co-ordinator of Care Organisation Public Enlightenment, is the primary weapon through which cancer can be detected early.
What are you waiting for?